Emerging Use of Bacteriophages, Natural Predators of Bacteria, to Combat Antibiotic Resistance in the Clinic and Beyond: A Review of the Field and Biosafety Assessment

Introduction: Bacteriophages (or phages) are viruses that infect and replicate within bacteria. Widespread use of antibiotics during World War II curtailed phage research in the western world. Unfortunately, clinical deployment of antibiotics has led to the prevalence of antibiotic resistance becoming so severe that the World Health Organization (WHO) has warned about the prospect of a postantibiotic world. The WHO is encouraging research into clinical use of bacteriophages as a means of countering antibiotic resistance. Methods: This review summarizes advances in phage research, particularly as it pertains to clinical use. Topics covered include considerations for research and development, genetic engineering, biosafety, One Health (clinical, veterinary, and agricultural use), as well as environmental and regulatory issues. Conclusions: Research and development of phage therapy is a promising avenue for combating the dangerous rise in antibiotic resistance and may eventually become a standard medical countermeasure to complement or replace antibiotics.